| 1. |
- Linde, Mattias, 1966, et al.
(författare)
-
Adherence to migraine prophylaxis at a Swedish tertiary clinic. A cross-sectional study of influence of disease features
- 2007
-
Ingår i: The 13th Congress of the International Headache Society, Stockholm, juni 2007.
-
Konferensbidrag (refereegranskat)abstract
- Introduction The efficacy of mainly the more recently developed prophylactic treatments of migraine have been well established in a large number of randomised controlled trials. However, such trials tend to focus on the effects of the drug in an ideal setting and rather underestimate the impact of non-compliance, which generally escapes detection by the physician. This poorly understood phenomenon was further looked at in a naturalistic setting. Methods A consecutive sample of 175 migraineurs (85% women, mean age 4512, range 19-79 years) with a current prescription of pharmacological prophylaxis were studied at a Swedish headache specialist clinic. Adherence was self-reported with the Medication Adherence Report Scale (MARS, possible range of scores 5-25). Logistic regression analysis was performed to analyze the association between MARS and frequency of attacks, number of days with migraine per month, attack duration, presence of prodrome (68%), presence of aura (41%, some or all attacks), mean intensity of pain, and recovery between attacks. Results The mean frequency of migraine was 6.5 days / month, and 68% did not recover completely interictally. The mean MARS score was 22.52.8. One third (35%) was not highly adherent. Neither demographic characteristics, nor any of the studied disease specific variables were significantly associated with adherence. Discussion The full benefit of prophylactic migraine medication cannot be realised at currently achieved levels of adherence. Characteristics of the headaches per se are the starting point of patients’ decision-making. However, the present study indicates that other factors play a more important role in this complicated process.
|
|
| 2. |
- Hedenrud, Tove, 1967, et al.
(författare)
-
Beliefs about medicines and adherence among Swedish migraineurs.
- 2007
-
Ingår i: The 13th Congress of the International Headache Society, Stockholm, juni 2007..
-
Konferensbidrag (refereegranskat)abstract
- Objective The aim was to analyze whether beliefs about medicines are associated with adherence to prophylactic medication among Swedish migraineurs. Methods A questionnaire was distributed consecutively to migraineurs attending a tertiary clinic. All participants were prescribed prophylactic medication. The questionnaire comprised e.g. background questions, beliefs about medicines (BMQ), and self-reported adherence (MARS). The General BMQ comprises three subparts: General Harm, General Overuse, and General Benefit. The specific part of the BMQ has two subparts: Specific Necessity and Specific Concerns. For the BMQ Specific, a necessity–concerns differential was calculated for each participant. A logistic regression analysis was performed to analyze the association between beliefs about medicines and adherence to prophylactic medication. Results Of the 175 participants, 15% were male and more than half of the participants were aged 45 years and over. Fifty percent had a university degree. Sixty-four percent were considered adherent. There was no significant difference in adherence between gender, age groups, or by educational level. Respondents with only compulsory school were less concerned about the long-term effects of medications and had a higher necessity–concern differential. In the logistic regression analysis, no variable was significantly associated with adherence. Conclusions The present study showed no association between beliefs about medication and adherence. We recommend that lack of adherence to migraine prophylactic drugs should be considered more often, looked for, and addressed in order to identify sufferers with an unnecessarily high migraine-associated disability. This assumes greater attention to the problem amongst both physicians and researchers in all countries.
|
|
